[Hiring] Medical Claims Processor REMOTE USA
Position: Medical Claims Processor – Remote
Date Posted: October 4, 2025
Industry: Healthcare / Administrative Support / Remote Work
Employment Type: Full Time
Experience: 1-3 years in Healthcare Claims Processing
Qualification: High school diploma or GED
Salary: $18.00/hour
Location: Plano, TX — Remote, United States
Company: NTT DATA North America
Description:
NTT DATA North America is seeking a dedicated Remote Medical Claims Processor to join our team and support our end client. This role is ideal for candidates who are detail-oriented, tech-savvy, and experienced in healthcare claims processing.
Role Responsibilities:
• Process professional claim forms submitted by providers.
• Review policies and benefits accurately.
• Comply with HIPAA, confidentiality, and PHI regulations.
• Complete all NTT DATA/client compliance training on time.
• Work independently to research, review, and act on claims.
• Prioritize tasks and adjudicate claims according to SLAs.
• Follow client-defined workflows and guidelines for claim adjudication.
• Maintain productivity and quality targets to avoid penalties.
• Ensure quality scores of 98.5% PA and 99.75% FA are met.
• Respond promptly to claims received via email.
• Accurately calculate claims payable using the applicable methodology/fee schedule.
Required Skills/Experience:
• 1-3 years of hands-on experience in healthcare claims processing.
• 2+ years of experience using Windows applications, navigating multiple systems, and learning new software tools.
• High school diploma or GED.
Preferences:
• Experience with Amisys and/or Xcelys preferred.
• Strong time management skills and ability to adapt in a dynamic environment.
• Effective problem-solving, research, and analytical abilities.
• Prior experience performing P&Q work remotely from a queue-based system.
Work Schedule:
• Must be able to work 7am – 4pm CST online/remote. Training is required on-camera.
About NTT DATA:
NTT DATA is a $30+ billion global innovator in business and technology services, serving 75% of the Fortune Global 100. We provide consulting, AI and data solutions, application development, infrastructure, and connectivity services. Committed to diversity and inclusion, we provide a robust benefits package including medical, dental, vision, life, AD&D, disability coverage, paid time off, 401k matching, and more.
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